Heart Care

Anxiety Disorders May Increase Heart Attack and Stroke Risk

Anxiety disorders may increase the risk of heart attack, stroke, heart failure, and death in people with heart disease, a new study suggests.

Researchers have studied depression in patients with coronary heart disease, but relatively few studies have examined the role of anxiety.

The study on anxiety was reported in the journal Archives of General Psychiatry.

Many factors may account for the increase in risk linked with anxiety, says study author Elisabeth J. Martens, Ph.D., of Tilburg University in the Netherlands.

Anxiety a Common Problem

Anywhere from 24 percent to 31 percent of patients with heart disease also have symptoms of anxiety, Dr. Martens notes.

Anxiety may be linked with surges in "fight or flight" hormones called catecholamines that may be related to heart risks.

Or it is possible that people with anxiety may be more likely to seek medical care when they have symptoms of a cardiovascular event (although researchers noted this would not explain the higher rates of death).

Or a common underlying factor may increase the risk of both anxiety and heart events.

The research included over 1,000 people with stable coronary heart disease who were assessed for anxiety disorder at the start of the study and then followed for an average of 5.6 years.

During that time, there were a total of 371 cardiovascular events (heart attacks or other incidents that may cause damage to the heart).

The yearly rate of cardiovascular events was 9.6 percent among the 106 patients with generalized anxiety disorder and 6.6 percent among the other 909 patients.

Anxiety Link to Heart Problems Considerable

After adjusting for a number of factors - such as other health problems, heart disease severity, and medication use - the researchers concluded that generalized anxiety disorder was associated with a 74 percent increased risk of cardiovascular events.

"These findings have implications for clinical practice and research," notes Dr. Martens, since the evaluation and treatment of anxiety might now "be considered as part of the comprehensive management of patients with coronary heart disease."

The research team adds that scientists need research programs to help understand the impact of anxiety disorders on medical prognosis, including that of heart disease, and to develop evidence-based approaches to patient care.

Always consult your physician or other healthcare provider for more information.

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Although GAD may be accompanied by depression, substance abuse, or another anxiety disorder, impairment is usually mild.

People with this disorder usually realize that their anxiety is more intense than the situation warrants, but cannot rid themselves of these irrational concerns. The following are the most common symptoms of GAD:

trouble falling or staying asleep

trembling

twitching

muscle tension

headaches

irritability

sweating

hot flashes

lightheadedness and/or difficulty breathing

nausea

frequent urination

Always consult your physician or other healthcare provider for more information.